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一、毒性反应大剂量的青霉素(每日几千万单位),会引起肌肉阵发性挛缩,反射亢进,惊厥或昏迷。静脉用药所造成的高浓度,心脏直视手术时的体外循环以及神经系统的特殊敏感性(如患脑膜炎后),都会明显地促进这些反应。肌肉注射后,也曾观察到类似的中枢神经系统反应。由于青霉素及其代谢产物大部分通过肾脏排泄,故肾机能不全时,易出现这些反应。鞘内注射1万单位的青霉素和对神经系统局部应用高浓度青霉素(尤其在手术时对脑部用药),均能引起类似反
First, the toxicity of large doses of penicillin (tens of millions of units a day), can cause paroxysmal muscle contractures, hyperreflexia, convulsions or coma. High concentrations caused by intravenous drug use, cardiopulmonary bypass during open-heart surgery, and the specific sensitivity of the nervous system, such as after meningitis, contribute significantly to these responses. A similar central nervous system response has also been observed after intramuscular injection. As penicillin and its metabolites are mostly excreted through the kidneys, so when the renal insufficiency, prone to these reactions. An intrathecal injection of penicillin at 10,000 units and topical application of high concentrations of penicillin to the nervous system (especially on the brain during surgery) can cause similar responses